| NPI | 1457472839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: VT 042-0012000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042-0012000) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2025-09-25 |